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SHAWNEE MISSION SURGERY CENTER, LLC 9301 W 74th Street Suite 300 Shawnee Mission, KS 66204 913-632-9333 Fax #: 913-789-1886 We are thankful that you and your surgeon have elected to schedule your surgery at the Shawnee Mission Surgery Center. The staff has already begun the process to make your visit to our facility as comfortable and stress-free as possible. Please pre-register online or fill out the patient pre-registration and history form within 48 hours after your surgery is scheduled. A pre-surgery admissions nurse will call you two to three days prior to your procedure to review your history, give you instructions and answer your questions. If a pre-surgery nurse has not contacted you within 24 hours prior to your surgery, please contact us at 913-632-9333. The Pre-Surgery Clinic hours are 8:30 am – 5:00 pm Monday Friday Co-payments must be paid on the day of surgery. If you are required to make any other financial payment such as co-insurance or deductable, you will be contacted by our staff. We accept cash, credit cards or check. Cosmetic procedure payments are to be paid in full on the day of surgery. No personal checks will be accepted. Surgery Date________ Surgery Time_________ Arrival Time_________ Please bring your insurance card and/or completed insurance form. PRE-SURGERY INSTRUCTIONS To allow time for the admitting process, please arrive a minimum of 90 minutes before surgery unless otherwise instructed by the Pre-Surgery Clinic. For your own safety and protection arrange for a responsible adult to accompany you to the Surgery Center, receive discharge instructions, drive you home and stay with you for the first 12 hours following your surgery. Do not drink or eat anything (including water, gum and mints) after midnight the night before your surgery unless you are instructed to do otherwise. Undigested food in your stomach can cause serious complications. Take only the prescription medications approved by the Pre-Surgery admissions nurse on the day of your surgery. To minimize the chance of infection, bathe or shower both the evening before and the morning of surgery with an antibacterial soap such as Dial or Safeguard. You may brush your teeth and rinse your mouth on the day of your surgery, taking care not to swallow any liquids. Wear loose-fitting, comfortable clothing. It is best to leave all valuables, jewelry (including all body piercings) at home or with a family member. If you wear contacts or eyeglasses, please bring the appropriate soaking solution and/or storage case with you. If you have sleep apnea please bring your C-Pap or Bi-Pap machine with you on the day of your surgery. PRE-SURGERY INSTRUCTIONS FOR LOCAL ANESTHESIA (No sedation just the area that is being operated on is numbed) To allow time for the admitting process, please arrive 30 minutes before surgery unless otherwise instructed by the Pre-Surgery Clinic. We encourage you to eat a light meal before your procedure. You may take your daily medications unless instructed otherwise. To minimize the chance of infection, bathe or shower both the evening before and the morning of surgery with an antibacterial soap such as Dial or Safeguard. Surgery for Children: Please bring a favorite toy or blanket for added reassurance. Children may be brought to the surgery center in their pajamas and socks or slippers. Please bring an extra pair of clothing (including underclothes). Please bring a bottle or tippy cup if your child cannot drink from a cup. A parent or guardian is required to stay at the surgery center throughout the child’s surgical procedure and recovery (under age 18). Legal guardians must bring proof of legal guardianship.